Healthcare Provider Details

I. General information

NPI: 1669766457
Provider Name (Legal Business Name): PEACEHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

787 WOODLAND ACRES LN
EUGENE OR
97402-9378
US

IV. Provider business mailing address

3333 RIVERBEND DR
SPRINGFIELD OR
97477-8800
US

V. Phone/Fax

Practice location:
  • Phone: 541-285-6226
  • Fax:
Mailing address:
  • Phone: 541-222-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MEL PAYNE
Title or Position: CEO
Credential:
Phone: 541-222-2000